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General NPI Number Information
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NPI Number | 1528338423
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Entity Type | Individual
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Provider Name | DENISE IRENE HOUCK NP
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Gender | Female
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Dates
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Enumeration Date | 01/09/2012
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Last Update Date | 09/02/2016
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Provider Practice Location Address
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Address Line | 1800 NE MARKET DRIVE
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City | FAIRVIEW
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State | OR
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Zip | 97024
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Country | US
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Telephone | 503-660-0600
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Fax |
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Provider Business Mailing Address
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Address Line | 21824 NE HEARTWOOD CIR
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City | FAIRVIEW
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State | OR
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Zip | 97024-6787
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Country | US
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Telephone | 503-660-0600
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 21545
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License Number State | CA
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